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Biomedical subjects

R G Simmons

Publications and source records attributed to R G Simmons.

At least 19 recordsLinked to original sources
PubMed1990

Quality-of-life issues for end-stage renal disease patients.

Given the importance of making comparisons regarding quality-of-life issues for end-stage renal disease (ESRD) patients, the research presented here first compares 766 patients who experienced one of the following therapies for at least 1 year: (1) center hemodialysis, (2) continuous ambulatory peritoneal dialysis (CAPD), or (3) successful transplantation (one cohort of patients from the 1970s, a second cohort from 1980 to 1984). Second, since the most recent transplant group was randomized to two alternative immunosuppressive drug regimens, we compared the quality of life of the patients on cyclosporine/prednisone therapy (N = 51) and the patients on a conventional immunosuppressive therapy (antilymphocyte globulin/prednisone/azathioprine; N = 40). Patients had to be age 19 to 56 years and nondiabetic to be included in this research. Data were collected with survey questionnaires containing measures of physical, emotional, and social well-being, vocational rehabilitation, sexual adjustment, and marital and family adjustment. Case mix or background differences were controlled as much as possible using an analysis of covariance (ANCOVA) and comparison of adjusted means. Our results show that the successful transplant patients scored higher than both dialysis groups (P less than 0.05 for nine of 11 measures) on almost all variables, demonstrating a higher quality of life. The effect of a failed transplant on quality of life was also examined. In terms of the recent transplant patients, the cyclosporine group scored consistently higher on all physical, emotional, and social well-being measures (excluding males' vocational rehabilitation), although differences are not always significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

The advantage of multiple measures of quality of life.

The concept of "quality of life" is rich and multi-faceted. In the present paper, we argue that the very richness of the concept requires that we (a) evaluate multiple dimensions of quality of life in our studies and (b) include multi-item assessments of each dimension selected for study. Conceptual and psychometric advantages which accrue by using multiple measures are delineated. We discuss the way in which the use of multiple measures affects the selection of instruments, the source of information, and the mode of data collection. In addition, the application of multi-item assessments to the construction of health status indices is considered along with their use in health policy and cost-benefit analyses.

Data Collection↗
PubMed1990

Quality of life and rehabilitation differences among four end-stage renal disease therapy groups.

This study investigates the quality of life of patients on alternative therapies for end-stage renal disease. The quality of life of 766 patients who experienced one of the following therapies for at least one year are compared: a successful transplant performed in the 1970's (N = 82), a successful transplant performed in 1980-1984 (N = 91), in-center hemodialysis (N = 83, 8 centers), and continuous ambulatory peritoneal dialyses (CAPD) (N = 510, 185 centers). All patients were aged 19-56 and nondiabetic. Survey questionnaires were administered containing measures of physical, emotional and social well-being, vocational rehabilitation, and sexual adjustment. Case-mix differences were controlled, insofar as possible, with an Analysis of Covariance; adjusted means were compared. Findings indicate that the quality of life for successful transplant patients exceeds that of both dialysis groups for almost all variables (p less than 0.05 for 9/11 measures). This advantage persists when transplant patients are compared to dialysis patients who have experienced no prior, failed therapies.

Adolescent↗
PubMed1988

Quality of life after kidney transplantation. A prospective, randomized comparison of cyclosporine and conventional immunosuppressive therapy.

The aim of this research is to compare the quality of life after kidney transplantation for patients treated with cyclosporine versus conventional immunosuppressive therapy. This evaluation assumes particular importance given the high cost of cyclosporine, the resistance of the government to cover these costs, and the absence in some series (including this one) of significant differences in patient and kidney survival. This study is based on a randomized, stratified, prospective trial and concentrates on nondiabetic patients from ages 19 to 56 at 1-year posttransplant. Patients on cyclosporine show significant advantages in physical, emotional, and social well-being. Differences for 5 out of 10 indicators of quality of life were significant at the P less than or equal to .05 level. Significant differences are found on health satisfaction, happiness measures, indices of overall life satisfaction and well-being, perceived adjustment of the family, and female (not male) vocational rehabilitation. The fewer number of episodes of rejection and infection are, in part, responsible for these advantages in quality of life for cyclosporine patients.

Actuarial Analysis↗
PubMed1987

The impact of cumulative change in early adolescence.

This article examines the impact of experiencing several major life transitions simultaneously in early adolescence. For many children, entry into the new life period of adolescence is marked by the transition from a relatively intimate elementary school setting into a more complex, impersonal junior high school environment. This major shift in organizational context is often accompanied by dramatic changes in biology and social definition. We hypothesized that transitions will be easier for children to cope with if the various adolescent changes come into focus at different stages rather than simultaneously. In a longitudinal study conducted in a large Midwestern city, schoolchildren were followed from sixth into seventh grade in 2 different types of school systems. The effect of multiple life changes (school transition, pubertal development, early dating behavior, residential mobility, family disruption) on students' self-esteem, academic grade-point average, and participation in extracurricular activities was analyzed. The results identify children who are forced to cope with several life transitions concurrently as a group at risk. Theoretical implications are discussed, with development of the notion that individuals need an "arena of comfort" in at least some spheres of their lives.

Adaptation, Psychological↗
PubMed1985

Some computer-based developments in sociology.

Sociological data sets are now being computer analyzed by means of a variety of sophisticated procedures, to produce results that reflect the intricacy of social life. Computers also are being used to conduct simulations of social processes based on mathematical models and to collect the data for analysis. Portable computers allow computing power to be used in field studies, and the relatively low cost of computers is expanding the range of sociologists who use them. While opening up new research opportunities, computers also bring certain problems for social researchers and teachers.

Computers↗
PubMed1984

Comparison of quality of life of patients on continuous ambulatory peritoneal dialysis, hemodialysis, and after transplantation.

Preliminary findings regarding quality of life of 458 renal patients treated by in-center hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), or transplantation indicate more favorable adjustment for CAPD patients when compared with center hemodialysis patients. Patients with a successful transplant show the highest overall adjustment when compared with both groups of dialysis patients.

Humans↗
PubMed1980

Long-term rehabilitation of transplant patients.

In conclusion, 148 patients transplanted between 1970-3 have been evaluated in terms of quality of life. Nondiabetic long-term transplant patients showed high levels of improvement and rehabilitation among multiple dimensions. While diabetic patients also showed improvement, many problems remain for this group.

Activities of Daily Living↗
PubMed1977

Related donors: costs and gains.

A quantitative, sociopsychologic study of 111 donors at 1 year after a successful transplant points to long-term emotional benefits rather than costs for most donors. While no one factor is highly predictive of donors who react less well, exclusion of extremely ambivalent donors would appear advisable, as would counseling help for other relatives who wish to donate despite normal fears.

Attitude to Health↗